Inpatient Facility Charge Table,,,,,,,,
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Item Code,Code Type,Description,Charge Type Indicator,Standard Room and Board Per Diem,Standard Ancillary Charge Per Diem,ICU Room and Board Per Diem,ICU Ancillary Charge Per Diem,Start Date
001,DRG,CRANIOTOMY AGE >17 W CC,S,"$1,629.44","$7,139.01","$3,465.75","$7,139.01",20061001
002,DRG,CRANIOTOMY AGE >17 W/O CC,S,"$1,752.12","$11,237.45","$3,845.99","$11,237.45",20061001
003,DRG,CRANIOTOMY AGE 0-17,S,"$2,011.76","$9,769.57","$6,959.87","$9,769.57",20061001
006,DRG,CARPAL TUNNEL RELEASE,S,"$1,871.10","$6,051.86","$3,040.87","$6,051.86",20061001
007,DRG,PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC,S,"$1,501.07","$5,092.42","$2,988.52","$5,092.42",20061001
008,DRG,PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC,S,"$1,525.24","$13,276.44","$2,979.09","$13,276.44",20061001
009,DRG,SPINAL DISORDERS & INJURIES,N,"$1,421.96","$3,373.87","$3,480.38","$3,373.87",20061001
010,DRG,NERVOUS SYSTEM NEOPLASMS W CC,N,"$1,545.86","$3,345.08","$2,774.79","$3,345.08",20061001
011,DRG,NERVOUS SYSTEM NEOPLASMS W/O CC,N,"$1,587.60","$4,504.40","$2,897.25","$4,504.40",20061001
012,DRG,DEGENERATIVE NERVOUS SYSTEM DISORDERS,N,"$1,454.57","$2,269.51","$2,628.39","$2,269.51",20061001
013,DRG,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA,N,"$1,489.60","$2,838.15","$2,700.67","$2,838.15",20061001
014,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION,N,"$1,323.42","$3,625.45","$2,625.98","$3,625.45",20061001
015,DRG,NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT,N,"$1,305.15","$3,823.34","$2,326.98","$3,823.34",20061001
016,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,N,"$1,411.83","$3,373.08","$2,443.36","$3,373.08",20061001
017,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC,N,"$1,518.48","$4,149.95","$2,532.71","$4,149.95",20061001
018,DRG,CRANIAL & PERIPHERAL NERVE DISORDERS W CC,N,"$1,356.97","$3,207.13","$2,348.52","$3,207.13",20061001
019,DRG,CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC,N,"$1,482.16","$3,732.56","$2,467.52","$3,732.56",20061001
021,DRG,VIRAL MENINGITIS,N,"$1,460.87","$4,359.42","$2,800.62","$4,359.42",20061001
022,DRG,HYPERTENSIVE ENCEPHALOPATHY,N,"$1,408.19","$3,950.48","$2,859.10","$3,950.48",20061001
023,DRG,NONTRAUMATIC STUPOR & COMA,N,"$1,499.89","$3,846.98","$2,888.45","$3,846.98",20061001
026,DRG,SEIZURE & HEADACHE AGE 0-17,N,"$4,418.59","$17,205.83","$14,626.06","$17,205.83",20061001
027,DRG,"TRAUMATIC STUPOR & COMA, COMA >1 HR",N,"$1,579.10","$5,321.25","$3,662.69","$5,321.25",20061001
028,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC",N,"$1,510.61","$3,855.14","$3,229.84","$3,855.14",20061001
029,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC",N,"$1,588.85","$3,789.99","$3,255.91","$3,789.99",20061001
030,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17",N,"$1,132.17","$2,134.09","$2,466.01","$2,134.09",20061001
031,DRG,CONCUSSION AGE >17 W CC,N,"$1,520.67","$4,644.55","$3,234.06","$4,644.55",20061001
032,DRG,CONCUSSION AGE >17 W/O CC,N,"$1,708.21","$5,720.27","$3,484.54","$5,720.27",20061001
033,DRG,CONCUSSION AGE 0-17,N,"$1,745.79","$3,631.60","$3,456.27","$3,631.60",20061001
034,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W CC,N,"$1,531.06","$3,496.77","$2,856.20","$3,496.77",20061001
035,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W/O CC,N,"$1,609.66","$3,818.03","$2,721.72","$3,818.03",20061001
036,DRG,RETINAL PROCEDURES,S,"$3,149.07","$16,870.23","$4,183.64","$16,870.23",20061001
037,DRG,ORBITAL PROCEDURES,S,"$1,883.53","$7,301.60","$3,765.46","$7,301.60",20061001
038,DRG,PRIMARY IRIS PROCEDURES,S,"$1,749.74","$3,204.99","$1,579.86","$3,204.99",20061001
039,DRG,LENS PROCEDURES WITH OR WITHOUT VITRECTOMY,S,"$2,088.50","$8,197.43","$2,376.70","$8,197.43",20061001
040,DRG,EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17,S,"$2,484.71","$6,942.90","$3,838.47","$6,942.90",20061001
041,DRG,EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17,S,"$1,466.99","$4,372.02","$2,742.44","$4,372.02",20061001
042,DRG,"INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS",S,"$1,873.02","$6,576.58","$3,339.25","$6,576.58",20061001
043,DRG,HYPHEMA,N,"$1,893.78","$3,717.45","$2,986.95","$3,717.45",20061001
044,DRG,ACUTE MAJOR EYE INFECTIONS,N,"$1,708.84","$2,369.80","$2,855.40","$2,369.80",20061001
045,DRG,NEUROLOGICAL EYE DISORDERS,N,"$1,578.62","$4,798.41","$2,881.45","$4,798.41",20061001
046,DRG,OTHER DISORDERS OF THE EYE AGE >17 W CC,N,"$1,538.63","$3,153.15","$2,888.52","$3,153.15",20061001
047,DRG,OTHER DISORDERS OF THE EYE AGE >17 W/O CC,N,"$1,726.64","$3,261.04","$2,781.99","$3,261.04",20061001
048,DRG,OTHER DISORDERS OF THE EYE AGE 0-17,N,"$1,374.70","$2,218.10","$2,283.51","$2,218.10",20061001
049,DRG,MAJOR HEAD & NECK PROCEDURES,S,"$1,682.43","$8,792.87","$3,623.91","$8,792.87",20061001
050,DRG,SIALOADENECTOMY,S,"$1,945.18","$13,448.63","$3,279.15","$13,448.63",20061001
051,DRG,SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY,S,"$2,137.53","$9,002.66","$3,618.59","$9,002.66",20061001
052,DRG,CLEFT LIP & PALATE REPAIR,S,"$1,184.76","$9,633.36","$2,597.54","$9,633.36",20061001
053,DRG,SINUS & MASTOID PROCEDURES AGE >17,S,"$1,569.93","$7,403.22","$3,167.00","$7,403.22",20061001
054,DRG,SINUS & MASTOID PROCEDURES AGE 0-17,S,"$1,286.00","$6,144.37","$2,787.44","$6,144.37",20061001
055,DRG,"MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES",S,"$1,850.03","$8,327.63","$3,981.59","$8,327.63",20061001
056,DRG,RHINOPLASTY,S,"$1,508.95","$8,137.10","$2,712.22","$8,137.10",20061001
057,DRG,"T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17",S,"$1,407.42","$6,004.90","$3,103.17","$6,004.90",20061001
058,DRG,"T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17",S,"$1,398.53","$4,938.58","$2,975.89","$4,938.58",20061001
059,DRG,"TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17",S,"$1,233.76","$6,951.05","$2,983.14","$6,951.05",20061001
060,DRG,"TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17",S,"$1,226.75","$6,926.72","$4,425.12","$6,926.72",20061001
061,DRG,MYRINGOTOMY W TUBE INSERTION AGE >17,S,"$1,642.81","$5,480.41","$3,386.92","$5,480.41",20061001
062,DRG,MYRINGOTOMY W TUBE INSERTION AGE 0-17,S,"$1,587.41","$4,536.64","$2,884.58","$4,536.64",20061001
063,DRG,"OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES",S,"$1,526.02","$6,160.61","$2,970.84","$6,160.61",20061001
064,DRG,"EAR, NOSE, MOUTH & THROAT MALIGNANCY",N,"$1,591.45","$3,478.98","$3,010.13","$3,478.98",20061001
065,DRG,DYSEQUILIBRIUM,N,"$1,478.75","$3,765.89","$2,576.15","$3,765.89",20061001
066,DRG,EPISTAXIS,N,"$1,401.40","$2,961.13","$2,743.97","$2,961.13",20061001
067,DRG,EPIGLOTTITIS,N,"$1,367.24","$3,142.52","$2,434.70","$3,142.52",20061001
068,DRG,OTITIS MEDIA & URI AGE >17 W CC,N,"$1,168.93","$2,603.30","$2,137.47","$2,603.30",20061001
069,DRG,OTITIS MEDIA & URI AGE >17 W/O CC,N,"$1,180.92","$2,537.15","$2,088.29","$2,537.15",20061001
070,DRG,OTITIS MEDIA & URI AGE 0-17,N,"$1,175.79","$2,686.56","$4,185.23","$2,686.56",20061001
071,DRG,LARYNGOTRACHEITIS,N,"$1,117.20","$2,412.60","$2,409.32","$2,412.60",20061001
072,DRG,NASAL TRAUMA & DEFORMITY,N,"$1,633.19","$4,505.16","$3,192.68","$4,505.16",20061001
073,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17",N,"$1,420.25","$3,208.08","$2,815.97","$3,208.08",20061001
074,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17",N,"$1,882.08","$3,610.79","$3,676.43","$3,610.79",20061001
075,DRG,MAJOR CHEST PROCEDURES,S,"$1,722.78","$6,594.95","$3,163.61","$6,594.95",20061001
076,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W CC,S,"$1,481.19","$4,690.32","$2,770.89","$4,690.32",20061001
077,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W/O CC,S,"$1,578.67","$5,702.55","$2,988.49","$5,702.55",20061001
078,DRG,PULMONARY EMBOLISM,N,"$1,229.99","$3,160.10","$2,183.38","$3,160.10",20061001
079,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC,N,"$1,336.24","$3,118.07","$2,419.86","$3,118.07",20061001
080,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC,N,"$1,235.94","$2,518.58","$2,120.17","$2,518.58",20061001
081,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17,N,$824.16,"$3,474.63","$2,427.80","$3,474.63",20061001
082,DRG,RESPIRATORY NEOPLASMS,N,"$1,386.22","$3,424.47","$2,407.73","$3,424.47",20061001
083,DRG,MAJOR CHEST TRAUMA W CC,N,"$1,283.49","$3,062.73","$2,602.25","$3,062.73",20061001
084,DRG,MAJOR CHEST TRAUMA W/O CC,N,"$1,456.37","$3,233.39","$2,859.87","$3,233.39",20061001
085,DRG,PLEURAL EFFUSION W CC,N,"$1,335.00","$3,313.28","$2,384.63","$3,313.28",20061001
086,DRG,PLEURAL EFFUSION W/O CC,N,"$1,520.77","$3,545.86","$2,664.98","$3,545.86",20061001
087,DRG,PULMONARY EDEMA & RESPIRATORY FAILURE,N,"$1,188.15","$3,120.44","$2,245.59","$3,120.44",20061001
088,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,N,"$1,146.62","$2,681.61","$2,139.83","$2,681.61",20061001
089,DRG,SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC,N,"$1,197.09","$2,779.21","$2,202.56","$2,779.21",20061001
090,DRG,SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC,N,"$1,160.51","$2,373.54","$1,994.96","$2,373.54",20061001
091,DRG,SIMPLE PNEUMONIA & PLEURISY AGE 0-17,N,"$1,241.44","$2,924.25","$2,771.30","$2,924.25",20061001
092,DRG,INTERSTITIAL LUNG DISEASE W CC,N,"$1,352.18","$3,256.85","$2,514.96","$3,256.85",20061001
093,DRG,INTERSTITIAL LUNG DISEASE W/O CC,N,"$1,395.44","$3,227.21","$2,344.06","$3,227.21",20061001
094,DRG,PNEUMOTHORAX W CC,N,"$1,222.73","$3,041.84","$2,372.03","$3,041.84",20061001
095,DRG,PNEUMOTHORAX W/O CC,N,"$1,291.40","$2,907.92","$2,502.98","$2,907.92",20061001
096,DRG,BRONCHITIS & ASTHMA AGE >17 W CC,N,"$1,215.67","$2,716.25","$2,306.80","$2,716.25",20061001
097,DRG,BRONCHITIS & ASTHMA AGE >17 W/O CC,N,"$1,243.38","$2,610.08","$2,391.73","$2,610.08",20061001
098,DRG,BRONCHITIS & ASTHMA AGE 0-17,N,"$3,032.20","$4,254.69","$20,041.13","$4,254.69",20061001
099,DRG,RESPIRATORY SIGNS & SYMPTOMS W CC,N,"$1,324.02","$3,920.14","$2,462.68","$3,920.14",20061001
100,DRG,RESPIRATORY SIGNS & SYMPTOMS W/O CC,N,"$1,441.69","$4,914.47","$2,583.50","$4,914.47",20061001
101,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES W CC,N,"$1,344.66","$3,397.22","$2,484.60","$3,397.22",20061001
102,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC,N,"$1,499.29","$4,034.63","$2,562.98","$4,034.63",20061001
103,DRG,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM,S,"$2,580.12","$18,001.71","$5,374.44","$18,001.71",20061001
104,DRG,CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W CARD CATH,S,"$1,945.25","$12,311.55","$3,624.93","$12,311.55",20061001
105,DRG,CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W/O CARD CATH,S,"$1,855.94","$14,046.60","$3,703.59","$14,046.60",20061001
106,DRG,CORONARY BYPASS W PTCA,S,"$1,502.07","$14,503.56","$3,068.66","$14,503.56",20061001
108,DRG,OTHER CARDIOTHORACIC PROCEDURES,S,"$1,585.91","$12,139.91","$3,283.32","$12,139.91",20061001
110,DRG,MAJOR CARDIOVASCULAR PROCEDURES W CC,S,"$1,546.44","$9,871.53","$3,125.16","$9,871.53",20061001
111,DRG,MAJOR CARDIOVASCULAR PROCEDURES W/O CC,S,"$1,613.07","$18,959.38","$3,101.00","$18,959.38",20061001
113,DRG,AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE,S,"$1,355.41","$3,924.19","$2,572.43","$3,924.19",20061001
114,DRG,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS,S,"$1,398.31","$3,373.48","$2,507.06","$3,373.48",20061001
117,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT,S,"$1,446.08","$5,908.88","$2,502.37","$5,908.88",20061001
118,DRG,CARDIAC PACEMAKER DEVICE REPLACEMENT,S,"$2,349.87","$15,294.36","$3,694.14","$15,294.36",20061001
119,DRG,VEIN LIGATION & STRIPPING,S,"$1,622.43","$5,002.46","$3,090.33","$5,002.46",20061001
120,DRG,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,S,"$1,616.95","$4,862.03","$3,105.14","$4,862.03",20061001
121,DRG,"CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE",N,"$1,428.70","$3,934.57","$2,669.99","$3,934.57",20061001
122,DRG,"CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE",N,"$1,370.85","$4,723.16","$2,583.88","$4,723.16",20061001
123,DRG,"CIRCULATORY DISORDERS W AMI, EXPIRED",N,"$1,402.55","$5,480.72","$2,944.16","$5,480.72",20061001
124,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG",N,"$1,491.44","$6,367.68","$2,613.17","$6,367.68",20061001
125,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG",N,"$1,411.86","$8,399.28","$2,365.29","$8,399.28",20061001
126,DRG,ACUTE & SUBACUTE ENDOCARDITIS,N,"$1,538.74","$3,512.89","$2,929.67","$3,512.89",20061001
127,DRG,HEART FAILURE & SHOCK,N,"$1,285.76","$3,009.64","$2,365.86","$3,009.64",20061001
128,DRG,DEEP VEIN THROMBOPHLEBITIS,N,"$1,291.20","$1,938.20","$2,445.40","$1,938.20",20061001
129,DRG,"CARDIAC ARREST, UNEXPLAINED",N,"$1,278.56","$8,209.15","$3,174.49","$8,209.15",20061001
130,DRG,PERIPHERAL VASCULAR DISORDERS W CC,N,"$1,357.22","$2,659.64","$2,491.29","$2,659.64",20061001
131,DRG,PERIPHERAL VASCULAR DISORDERS W/O CC,N,"$1,272.12","$2,184.68","$2,434.47","$2,184.68",20061001
132,DRG,ATHEROSCLEROSIS W CC,N,"$1,311.73","$3,530.98","$2,428.94","$3,530.98",20061001
133,DRG,ATHEROSCLEROSIS W/O CC,N,"$1,350.03","$3,023.85","$1,743.34","$3,023.85",20061001
134,DRG,HYPERTENSION,N,"$1,303.70","$3,101.95","$2,278.34","$3,101.95",20061001
135,DRG,CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC,N,"$1,551.35","$3,428.00","$2,878.88","$3,428.00",20061001
136,DRG,CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W/O CC,N,"$1,859.44","$4,002.87","$3,431.13","$4,002.87",20061001
137,DRG,CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17,N,"$1,365.60","$2,482.03","$2,525.78","$2,482.03",20061001
138,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,N,"$1,373.59","$3,294.55","$2,410.00","$3,294.55",20061001
139,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC,N,"$1,429.58","$3,459.56","$2,422.35","$3,459.56",20061001
140,DRG,ANGINA PECTORIS,N,"$1,160.48","$3,298.46","$2,199.34","$3,298.46",20061001
141,DRG,SYNCOPE & COLLAPSE W CC,N,"$1,565.49","$3,741.44","$2,632.11","$3,741.44",20061001
142,DRG,SYNCOPE & COLLAPSE W/O CC,N,"$1,785.40","$4,453.00","$2,948.03","$4,453.00",20061001
143,DRG,CHEST PAIN,N,"$1,463.19","$5,120.99","$2,476.78","$5,120.99",20061001
144,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,N,"$1,422.20","$3,852.77","$2,662.17","$3,852.77",20061001
145,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC,N,"$1,447.18","$4,029.77","$2,613.50","$4,029.77",20061001
146,DRG,RECTAL RESECTION W CC,S,"$1,430.11","$5,172.39","$2,907.22","$5,172.39",20061001
147,DRG,RECTAL RESECTION W/O CC,S,"$1,443.72","$5,478.58","$3,002.69","$5,478.58",20061001
149,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC,S,"$1,302.03","$4,912.20","$2,615.80","$4,912.20",20061001
150,DRG,PERITONEAL ADHESIOLYSIS W CC,S,"$1,319.85","$4,688.20","$2,749.81","$4,688.20",20061001
151,DRG,PERITONEAL ADHESIOLYSIS W/O CC,S,"$1,377.38","$5,056.26","$2,767.74","$5,056.26",20061001
152,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W CC,S,"$1,339.74","$4,340.30","$2,777.45","$4,340.30",20061001
153,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC,S,"$1,383.28","$4,473.35","$2,862.79","$4,473.35",20061001
155,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC",S,"$1,343.68","$7,124.71","$3,107.74","$7,124.71",20061001
156,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17",S,"$6,653.33","$6,734.17","$15,168.02","$6,734.17",20061001
157,DRG,ANAL & STOMAL PROCEDURES W CC,S,"$1,317.05","$4,200.16","$2,605.98","$4,200.16",20061001
158,DRG,ANAL & STOMAL PROCEDURES W/O CC,S,"$1,256.30","$4,924.69","$2,433.24","$4,924.69",20061001
159,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC,S,"$1,321.06","$5,440.84","$2,653.28","$5,440.84",20061001
160,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC,S,"$1,372.26","$7,044.90","$2,613.91","$7,044.90",20061001
161,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W CC,S,"$1,487.45","$5,129.34","$2,713.09","$5,129.34",20061001
162,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W/O CC,S,"$1,636.49","$7,538.91","$2,653.92","$7,538.91",20061001
163,DRG,HERNIA PROCEDURES AGE 0-17,S,"$2,276.79","$9,887.44","$5,194.19","$9,887.44",20061001
164,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC,S,"$1,268.08","$5,254.69","$2,654.72","$5,254.69",20061001
165,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC,S,"$1,356.83","$5,825.46","$2,924.44","$5,825.46",20061001
166,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC,S,"$1,269.45","$6,262.49","$2,590.14","$6,262.49",20061001
167,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC,S,"$1,458.99","$9,521.31","$2,603.71","$9,521.31",20061001
168,DRG,MOUTH PROCEDURES W CC,S,"$1,553.93","$5,568.25","$3,130.62","$5,568.25",20061001
169,DRG,MOUTH PROCEDURES W/O CC,S,"$1,845.56","$8,406.91","$3,705.98","$8,406.91",20061001
170,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC,S,"$1,443.05","$4,726.85","$2,792.18","$4,726.85",20061001
171,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC,S,"$1,417.52","$6,106.60","$2,727.09","$6,106.60",20061001
172,DRG,DIGESTIVE MALIGNANCY W CC,N,"$1,525.54","$3,383.33","$2,694.27","$3,383.33",20061001
173,DRG,DIGESTIVE MALIGNANCY W/O CC,N,"$1,532.48","$3,748.25","$2,807.63","$3,748.25",20061001
174,DRG,G.I. HEMORRHAGE W CC,N,"$1,292.90","$3,539.06","$2,572.11","$3,539.06",20061001
175,DRG,G.I. HEMORRHAGE W/O CC,N,"$1,433.00","$3,403.55","$2,651.67","$3,403.55",20061001
176,DRG,COMPLICATED PEPTIC ULCER,N,"$1,320.96","$3,805.67","$2,598.93","$3,805.67",20061001
177,DRG,UNCOMPLICATED PEPTIC ULCER W CC,N,"$1,188.30","$3,453.72","$2,003.94","$3,453.72",20061001
178,DRG,UNCOMPLICATED PEPTIC ULCER W/O CC,N,"$1,264.28","$4,055.97","$2,118.93","$4,055.97",20061001
179,DRG,INFLAMMATORY BOWEL DISEASE,N,"$1,336.98","$2,926.61","$2,306.80","$2,926.61",20061001
180,DRG,G.I. OBSTRUCTION W CC,N,"$1,267.15","$2,951.03","$2,419.54","$2,951.03",20061001
181,DRG,G.I. OBSTRUCTION W/O CC,N,"$1,314.06","$2,756.06","$2,334.31","$2,756.06",20061001
182,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC",N,"$1,266.84","$2,955.55","$2,284.43","$2,955.55",20061001
183,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC",N,"$1,307.41","$3,434.54","$2,253.87","$3,434.54",20061001
184,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17",N,"$2,396.82","$3,148.34","$2,622.37","$3,148.34",20061001
185,DRG,"DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17",N,"$1,422.56","$3,570.12","$2,826.87","$3,570.12",20061001
186,DRG,"DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17",N,"$1,357.38","$2,773.60","$2,691.65","$2,773.60",20061001
187,DRG,DENTAL EXTRACTIONS & RESTORATIONS,N,"$1,728.95","$4,078.12","$2,709.11","$4,078.12",20061001
188,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC,N,"$1,441.52","$3,509.58","$2,658.85","$3,509.58",20061001
189,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC,N,"$1,569.13","$3,455.46","$2,568.33","$3,455.46",20061001
190,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17,N,"$1,588.04","$3,759.56","$5,332.73","$3,759.56",20061001
191,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W CC",S,"$1,780.80","$7,577.90","$3,751.31","$7,577.90",20061001
192,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W/O CC",S,"$1,854.22","$8,211.97","$3,845.84","$8,211.97",20061001
193,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC,S,"$1,485.04","$5,266.97","$2,885.79","$5,266.97",20061001
194,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC,S,"$1,495.70","$5,265.41","$3,422.43","$5,265.41",20061001
195,DRG,CHOLECYSTECTOMY W C.D.E. W CC,S,"$1,243.62","$5,109.46","$2,511.70","$5,109.46",20061001
196,DRG,CHOLECYSTECTOMY W C.D.E. W/O CC,S,"$1,221.69","$5,908.48","$2,593.27","$5,908.48",20061001
197,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC,S,"$1,281.86","$5,012.90","$2,696.26","$5,012.90",20061001
198,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC,S,"$1,201.41","$4,828.97","$2,265.75","$4,828.97",20061001
199,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY,S,"$1,415.55","$5,074.52","$2,663.44","$5,074.52",20061001
200,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY,S,"$1,535.98","$6,191.40","$3,193.90","$6,191.40",20061001
201,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES,S,"$1,643.74","$5,556.37","$3,443.89","$5,556.37",20061001
202,DRG,CIRRHOSIS & ALCOHOLIC HEPATITIS,N,"$1,484.95","$3,989.41","$2,975.68","$3,989.41",20061001
203,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS,N,"$1,542.50","$3,795.34","$2,852.22","$3,795.34",20061001
204,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,N,"$1,245.29","$3,499.72","$2,380.17","$3,499.72",20061001
205,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC",N,"$1,508.98","$3,714.77","$2,968.29","$3,714.77",20061001
206,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC",N,"$1,524.88","$3,618.78","$2,383.57","$3,618.78",20061001
207,DRG,DISORDERS OF THE BILIARY TRACT W CC,N,"$1,403.67","$3,988.02","$2,496.41","$3,988.02",20061001
208,DRG,DISORDERS OF THE BILIARY TRACT W/O CC,N,"$1,431.72","$4,408.02","$2,415.30","$4,408.02",20061001
210,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC,S,"$1,284.27","$5,146.14","$2,547.49","$5,146.14",20061001
211,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC,S,"$1,337.23","$5,417.41","$2,531.54","$5,417.41",20061001
212,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17,S,"$3,142.95","$19,369.83","$4,680.21","$19,369.83",20061001
213,DRG,AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS,S,"$1,402.43","$3,985.81","$2,668.72","$3,985.81",20061001
216,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE,S,"$1,364.26","$6,716.37","$2,392.86","$6,716.37",20061001
217,DRG,"WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS",S,"$1,500.68","$4,010.64","$3,083.50","$4,010.64",20061001
218,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC",S,"$1,310.62","$6,023.42","$2,523.68","$6,023.42",20061001
219,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC",S,"$1,320.77","$7,209.04","$2,364.86","$7,209.04",20061001
220,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17",S,"$1,599.04","$6,540.99","$3,308.02","$6,540.99",20061001
223,DRG,"MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC",S,"$1,351.21","$7,456.17","$2,472.14","$7,456.17",20061001
224,DRG,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC",S,"$1,433.05","$10,213.11","$2,628.31","$10,213.11",20061001
225,DRG,FOOT PROCEDURES,S,"$1,464.14","$4,445.69","$2,895.14","$4,445.69",20061001
226,DRG,SOFT TISSUE PROCEDURES W CC,S,"$1,479.59","$4,789.04","$2,954.30","$4,789.04",20061001
227,DRG,SOFT TISSUE PROCEDURES W/O CC,S,"$1,502.70","$7,387.12","$2,844.23","$7,387.12",20061001
228,DRG,"MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC",S,"$1,496.78","$5,870.28","$3,649.32","$5,870.28",20061001
229,DRG,"HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC",S,"$1,439.72","$6,557.33","$2,708.19","$6,557.33",20061001
230,DRG,LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR,S,"$1,420.58","$5,095.27","$2,517.21","$5,095.27",20061001
232,DRG,ARTHROSCOPY,S,"$1,509.11","$7,813.71","$2,962.72","$7,813.71",20061001
233,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC,S,"$1,320.38","$5,667.21","$2,668.20","$5,667.21",20061001
234,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC,S,"$1,287.47","$10,094.65","$2,560.61","$10,094.65",20061001
235,DRG,FRACTURES OF FEMUR,N,"$1,306.93","$2,381.38","$2,479.12","$2,381.38",20061001
236,DRG,FRACTURES OF HIP & PELVIS,N,"$1,329.55","$2,436.41","$2,601.90","$2,436.41",20061001
237,DRG,"SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH",N,"$1,472.31","$2,651.28","$2,220.30","$2,651.28",20061001
238,DRG,OSTEOMYELITIS,N,"$1,454.00","$2,390.94","$2,410.55","$2,390.94",20061001
239,DRG,PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY,N,"$1,413.78","$2,738.82","$2,613.29","$2,738.82",20061001
240,DRG,CONNECTIVE TISSUE DISORDERS W CC,N,"$1,426.24","$3,782.74","$2,790.15","$3,782.74",20061001
241,DRG,CONNECTIVE TISSUE DISORDERS W/O CC,N,"$1,492.14","$3,259.71","$2,569.22","$3,259.71",20061001
242,DRG,SEPTIC ARTHRITIS,N,"$1,291.38","$2,326.13","$2,107.54","$2,326.13",20061001
243,DRG,MEDICAL BACK PROBLEMS,N,"$1,293.88","$2,681.35","$2,450.67","$2,681.35",20061001
244,DRG,BONE DISEASES & SPECIFIC ARTHROPATHIES W CC,N,"$1,430.99","$2,357.57","$2,508.94","$2,357.57",20061001
245,DRG,BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC,N,"$1,432.39","$2,116.67","$2,833.63","$2,116.67",20061001
246,DRG,NON-SPECIFIC ARTHROPATHIES,N,"$1,415.59","$2,636.92","$2,861.63","$2,636.92",20061001
247,DRG,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE,N,"$1,354.85","$2,824.04","$2,240.19","$2,824.04",20061001
248,DRG,"TENDONITIS, MYOSITIS & BURSITIS",N,"$1,457.09","$2,908.28","$2,743.01","$2,908.28",20061001
249,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE",N,"$1,323.37","$2,093.47","$2,701.01","$2,093.47",20061001
250,DRG,"FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W CC",N,"$1,469.96","$2,997.16","$2,662.67","$2,997.16",20061001
251,DRG,"FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC",N,"$1,488.01","$2,753.98","$3,040.17","$2,753.98",20061001
252,DRG,"FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE 0-17",N,"$1,311.13","$1,924.04","$2,639.95","$1,924.04",20061001
253,DRG,"FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC",N,"$1,357.53","$2,668.86","$2,684.71","$2,668.86",20061001
254,DRG,"FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC",N,"$1,420.29","$2,245.37","$2,667.49","$2,245.37",20061001
255,DRG,"FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17",N,"$1,262.51","$1,722.28","$2,474.67","$1,722.28",20061001
256,DRG,OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES,N,"$1,407.32","$2,560.08","$2,626.01","$2,560.08",20061001
257,DRG,TOTAL MASTECTOMY FOR MALIGNANCY W CC,S,"$1,390.79","$7,532.25","$2,554.68","$7,532.25",20061001
258,DRG,TOTAL MASTECTOMY FOR MALIGNANCY W/O CC,S,"$1,355.64","$9,625.30","$2,624.84","$9,625.30",20061001
259,DRG,SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC,S,"$1,762.67","$8,132.92","$2,790.80","$8,132.92",20061001
260,DRG,SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC,S,"$1,694.56","$12,577.86","$3,202.01","$12,577.86",20061001
261,DRG,BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION,S,"$1,638.30","$10,313.21","$3,967.12","$10,313.21",20061001
262,DRG,BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY,S,"$1,473.36","$4,528.24","$2,244.07","$4,528.24",20061001
263,DRG,SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC,S,"$1,390.99","$2,776.98","$2,745.25","$2,776.98",20061001
264,DRG,SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC,S,"$1,343.89","$2,834.26","$2,420.02","$2,834.26",20061001
265,DRG,SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC,S,"$1,706.54","$5,052.97","$4,240.98","$5,052.97",20061001
266,DRG,SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC,S,"$1,878.09","$7,972.36","$4,078.31","$7,972.36",20061001
267,DRG,PERIANAL & PILONIDAL PROCEDURES,S,"$1,370.63","$4,337.05","$2,358.67","$4,337.05",20061001
268,DRG,"SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES",S,"$1,487.42","$7,182.06","$3,051.42","$7,182.06",20061001
269,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W CC",S,"$1,432.67","$3,717.28","$2,912.34","$3,717.28",20061001
270,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC",S,"$1,456.56","$4,915.73","$3,002.92","$4,915.73",20061001
271,DRG,SKIN ULCERS,N,"$1,335.97","$2,048.29","$2,409.06","$2,048.29",20061001
272,DRG,MAJOR SKIN DISORDERS W CC,N,"$1,419.13","$2,710.65","$3,039.56","$2,710.65",20061001
273,DRG,MAJOR SKIN DISORDERS W/O CC,N,"$1,397.17","$2,354.37","$2,889.77","$2,354.37",20061001
274,DRG,MALIGNANT BREAST DISORDERS W CC,N,"$1,416.72","$2,467.35","$2,266.70","$2,467.35",20061001
275,DRG,MALIGNANT BREAST DISORDERS W/O CC,N,"$1,385.34","$3,005.62","$2,231.89","$3,005.62",20061001
276,DRG,NON-MALIGANT BREAST DISORDERS,N,"$1,394.63","$2,379.58","$1,977.68","$2,379.58",20061001
277,DRG,CELLULITIS AGE >17 W CC,N,"$1,413.53","$2,372.39","$2,559.46","$2,372.39",20061001
278,DRG,CELLULITIS AGE >17 W/O CC,N,"$1,343.51","$1,985.05","$2,235.64","$1,985.05",20061001
279,DRG,CELLULITIS AGE 0-17,N,"$1,474.52","$2,036.40","$2,590.85","$2,036.40",20061001
280,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC",N,"$1,374.17","$2,901.25","$2,683.06","$2,901.25",20061001
281,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC",N,"$1,458.76","$2,962.11","$2,741.17","$2,962.11",20061001
282,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17",N,"$1,382.08","$2,199.42","$2,676.52","$2,199.42",20061001
283,DRG,MINOR SKIN DISORDERS W CC,N,"$1,430.94","$2,524.24","$2,706.24","$2,524.24",20061001
284,DRG,MINOR SKIN DISORDERS W/O CC,N,"$1,434.81","$2,397.59","$2,760.35","$2,397.59",20061001
285,DRG,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS",S,"$1,387.57","$3,479.43","$2,698.50","$3,479.43",20061001
286,DRG,ADRENAL & PITUITARY PROCEDURES,S,"$1,581.88","$8,551.16","$3,456.92","$8,551.16",20061001
287,DRG,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS",S,"$1,402.28","$2,862.28","$2,604.42","$2,862.28",20061001
288,DRG,O.R. PROCEDURES FOR OBESITY,S,"$1,420.02","$12,262.08","$2,990.75","$12,262.08",20061001
289,DRG,PARATHYROID PROCEDURES,S,"$1,699.92","$10,019.97","$3,356.51","$10,019.97",20061001
290,DRG,THYROID PROCEDURES,S,"$1,551.23","$10,622.81","$3,365.44","$10,622.81",20061001
291,DRG,THYROGLOSSAL PROCEDURES,S,"$2,073.81","$11,108.55","$4,001.86","$11,108.55",20061001
292,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC",S,"$1,599.78","$4,834.52","$3,008.13","$4,834.52",20061001
293,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC",S,"$1,664.91","$6,741.55","$3,674.95","$6,741.55",20061001
294,DRG,DIABETES AGE >35,N,"$1,445.07","$2,787.08","$2,731.98","$2,787.08",20061001
295,DRG,DIABETES AGE 0-35,N,"$1,166.62","$3,211.94","$2,501.86","$3,211.94",20061001
296,DRG,NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC,N,"$1,285.94","$2,577.18","$2,334.74","$2,577.18",20061001
297,DRG,NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC,N,"$1,298.91","$2,321.02","$2,348.07","$2,321.02",20061001
298,DRG,NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17,N,"$2,093.76","$3,602.39","$3,947.26","$3,602.39",20061001
299,DRG,INBORN ERRORS OF METABOLISM,N,"$1,204.86","$3,659.90","$2,740.77","$3,659.90",20061001
300,DRG,ENDOCRINE DISORDERS W CC,N,"$1,424.92","$3,074.66","$2,704.95","$3,074.66",20061001
301,DRG,ENDOCRINE DISORDERS W/O CC,N,"$1,498.64","$3,221.13","$2,740.14","$3,221.13",20061001
302,DRG,KIDNEY TRANSPLANT,S,"$2,236.33","$19,819.10","$4,062.92","$19,819.10",20061001
303,DRG,"KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM",S,"$1,474.84","$6,299.91","$2,999.02","$6,299.91",20061001
304,DRG,"KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC",S,"$1,637.59","$5,726.66","$3,153.32","$5,726.66",20061001
305,DRG,"KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC",S,"$1,469.01","$8,508.31","$2,762.39","$8,508.31",20061001
306,DRG,PROSTATECTOMY W CC,S,"$1,490.72","$4,190.50","$2,539.51","$4,190.50",20061001
307,DRG,PROSTATECTOMY W/O CC,S,"$1,439.06","$7,126.76","$2,984.65","$7,126.76",20061001
308,DRG,MINOR BLADDER PROCEDURES W CC,S,"$1,435.88","$5,069.46","$2,820.47","$5,069.46",20061001
309,DRG,MINOR BLADDER PROCEDURES W/O CC,S,"$1,448.71","$11,016.66","$2,588.24","$11,016.66",20061001
310,DRG,TRANSURETHRAL PROCEDURES W CC,S,"$1,534.86","$5,233.58","$2,795.11","$5,233.58",20061001
311,DRG,TRANSURETHRAL PROCEDURES W/O CC,S,"$1,865.96","$9,049.41","$3,180.32","$9,049.41",20061001
312,DRG,"URETHRAL PROCEDURES, AGE >17 W CC",S,"$1,552.59","$4,966.18","$2,874.72","$4,966.18",20061001
313,DRG,"URETHRAL PROCEDURES, AGE >17 W/O CC",S,"$2,121.34","$9,495.61","$2,722.69","$9,495.61",20061001
314,DRG,"URETHRAL PROCEDURES, AGE 0-17",S,"$1,550.95","$4,917.23","$2,666.61","$4,917.23",20061001
315,DRG,OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES,S,"$1,583.70","$5,946.95","$2,841.50","$5,946.95",20061001
316,DRG,RENAL FAILURE,N,"$1,381.76","$3,239.07","$2,535.48","$3,239.07",20061001
317,DRG,ADMIT FOR RENAL DIALYSIS,N,"$1,292.62","$4,184.32","$2,371.78","$4,184.32",20061001
318,DRG,KIDNEY & URINARY TRACT NEOPLASMS W CC,N,"$1,382.52","$3,174.80","$2,691.17","$3,174.80",20061001
319,DRG,KIDNEY & URINARY TRACT NEOPLASMS W/O CC,N,"$1,960.33","$5,775.10","$2,701.73","$5,775.10",20061001
320,DRG,KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC,N,"$1,291.24","$2,539.77","$2,343.55","$2,539.77",20061001
321,DRG,KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC,N,"$1,265.15","$2,272.08","$2,167.42","$2,272.08",20061001
322,DRG,KIDNEY & URINARY TRACT INFECTIONS AGE 0-17,N,"$1,439.58","$3,059.43","$1,607.13","$3,059.43",20061001
323,DRG,"URINARY STONES W CC, &/OR ESW LITHOTRIPSY",N,"$1,338.96","$4,890.43","$2,408.15","$4,890.43",20061001
324,DRG,URINARY STONES W/O CC,N,"$1,246.28","$5,070.21","$2,474.28","$5,070.21",20061001
325,DRG,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC,N,"$1,515.70","$2,903.31","$2,728.09","$2,903.31",20061001
326,DRG,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC,N,"$1,610.07","$2,963.89","$2,850.66","$2,963.89",20061001
327,DRG,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE 0-17,N,"$1,459.15","$2,241.38","$2,593.38","$2,241.38",20061001
328,DRG,URETHRAL STRICTURE AGE >17 W CC,N,"$1,539.33","$3,683.17","$2,978.97","$3,683.17",20061001
329,DRG,URETHRAL STRICTURE AGE >17 W/O CC,N,"$3,030.46","$10,388.99","$5,067.39","$10,388.99",20061001
330,DRG,URETHRAL STRICTURE AGE 0-17,N,"$1,723.90","$3,638.59","$3,613.13","$3,638.59",20061001
331,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC,N,"$1,468.43","$3,509.64","$2,615.95","$3,509.64",20061001
332,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC,N,"$1,647.77","$4,116.30","$2,952.11","$4,116.30",20061001
333,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17,N,"$2,170.68","$4,019.29","$3,754.48","$4,019.29",20061001
334,DRG,MAJOR MALE PELVIC PROCEDURES W CC,S,"$1,363.16","$7,618.48","$2,805.33","$7,618.48",20061001
335,DRG,MAJOR MALE PELVIC PROCEDURES W/O CC,S,"$1,396.07","$10,873.33","$2,791.03","$10,873.33",20061001
336,DRG,TRANSURETHRAL PROSTATECTOMY W CC,S,"$1,376.61","$5,182.53","$2,637.62","$5,182.53",20061001
337,DRG,TRANSURETHRAL PROSTATECTOMY W/O CC,S,"$1,420.27","$7,123.93","$2,785.31","$7,123.93",20061001
338,DRG,"TESTES PROCEDURES, FOR MALIGNANCY",S,"$1,347.77","$4,689.29","$2,785.42","$4,689.29",20061001
339,DRG,"TESTES PROCEDURES, NON-MALIGNANCY AGE >17",S,"$1,344.14","$4,677.67","$3,541.95","$4,677.67",20061001
340,DRG,"TESTES PROCEDURES, NON-MALIGNANCY AGE 0-17",S,"$1,270.54","$3,843.07","$2,678.03","$3,843.07",20061001
341,DRG,PENIS PROCEDURES,S,"$1,583.85","$10,767.59","$3,382.06","$10,767.59",20061001
342,DRG,CIRCUMCISION AGE >17,S,"$1,203.69","$4,622.02","$1,806.81","$4,622.02",20061001
343,DRG,CIRCUMCISION AGE 0-17,S,"$1,098.46","$4,343.14","$2,049.30","$4,343.14",20061001
344,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY,S,"$1,762.32","$11,052.14","$2,996.01","$11,052.14",20061001
345,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXCEPT FOR MALIGNANCY,S,"$1,397.25","$3,906.53","$2,699.60","$3,906.53",20061001
346,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC",N,"$1,326.41","$2,425.19","$2,272.46","$2,425.19",20061001
347,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W/O CC",N,"$1,378.74","$3,738.50","$2,248.33","$3,738.50",20061001
348,DRG,BENIGN PROSTATIC HYPERTROPHY W CC,N,"$1,471.73","$2,753.47","$2,711.94","$2,753.47",20061001
349,DRG,BENIGN PROSTATIC HYPERTROPHY W/O CC,N,"$1,558.10","$2,607.22","$2,612.93","$2,607.22",20061001
350,DRG,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM,N,"$1,310.31","$2,605.41","$2,209.47","$2,605.41",20061001
351,DRG,"STERILIZATION, MALE",N,"$1,115.03","$3,064.01","$2,161.05","$3,064.01",20061001
352,DRG,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES,N,"$1,508.91","$3,097.71","$2,848.59","$3,097.71",20061001
353,DRG,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY",S,"$1,690.54","$6,559.59","$3,865.94","$6,559.59",20061001
354,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC",S,"$1,559.07","$5,459.84","$3,276.97","$5,459.84",20061001
355,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC",S,"$1,454.01","$6,299.49","$2,774.66","$6,299.49",20061001
356,DRG,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,S,"$1,239.69","$9,088.16","$2,564.11","$9,088.16",20061001
357,DRG,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY,S,"$1,506.75","$5,549.59","$3,115.92","$5,549.59",20061001
358,DRG,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC,S,"$1,263.28","$5,854.80","$2,704.55","$5,854.80",20061001
359,DRG,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC,S,"$1,248.72","$7,250.77","$2,624.95","$7,250.77",20061001
360,DRG,"VAGINA, CERVIX & VULVA PROCEDURES",S,"$1,234.96","$7,279.85","$2,453.51","$7,279.85",20061001
361,DRG,LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION,S,"$1,564.68","$9,183.64","$3,600.28","$9,183.64",20061001
362,DRG,ENDOSCOPIC TUBAL INTERRUPTION,S,"$1,101.78","$5,311.55","$2,228.97","$5,311.55",20061001
363,DRG,"D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY",S,"$1,784.44","$5,336.09","$2,959.88","$5,336.09",20061001
364,DRG,"D&C, CONIZATION EXCEPT FOR MALIGNANCY",S,"$1,609.96","$4,070.82","$3,082.33","$4,070.82",20061001
365,DRG,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES,S,"$1,425.41","$5,397.56","$3,254.89","$5,397.56",20061001
366,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC",N,"$1,406.27","$3,050.08","$2,805.05","$3,050.08",20061001
367,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC",N,"$1,846.38","$3,987.59","$3,987.10","$3,987.59",20061001
368,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM",N,"$1,335.98","$2,898.92","$2,513.41","$2,898.92",20061001
369,DRG,MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,N,"$1,518.97","$3,202.37","$2,475.85","$3,202.37",20061001
370,DRG,CESAREAN SECTION W CC,S,"$1,390.31","$3,426.51","$3,338.13","$3,426.51",20061001
371,DRG,CESAREAN SECTION W/O CC,S,"$1,364.76","$3,538.47","$3,766.41","$3,538.47",20061001
372,DRG,VAGINAL DELIVERY W COMPLICATING DIAGNOSES,N,"$1,248.61","$2,910.61","$2,244.93","$2,910.61",20061001
373,DRG,VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES,N,"$1,345.22","$3,126.23","$2,115.50","$3,126.23",20061001
374,DRG,VAGINAL DELIVERY W STERILIZATION &/OR D&C,S,"$1,467.48","$5,261.13","$4,956.33","$5,261.13",20061001
375,DRG,VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C,S,"$3,221.02","$8,804.37","$6,898.03","$8,804.37",20061001
376,DRG,POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE,N,"$1,435.64","$3,620.78","$3,042.88","$3,620.78",20061001
377,DRG,POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE,S,"$1,485.19","$7,283.70","$3,047.08","$7,283.70",20061001
378,DRG,ECTOPIC PREGNANCY,N,"$1,467.59","$7,790.44","$3,063.97","$7,790.44",20061001
379,DRG,THREATENED ABORTION,N,"$1,504.33","$1,894.93","$2,209.47","$1,894.93",20061001
380,DRG,ABORTION W/O D&C,N,"$2,316.96","$6,883.33","$4,714.63","$6,883.33",20061001
381,DRG,"ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",S,"$1,579.54","$8,134.75","$3,755.23","$8,134.75",20061001
382,DRG,FALSE LABOR,N,"$1,200.32","$1,834.74","$2,029.53","$1,834.74",20061001
383,DRG,OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS,N,"$1,503.56","$2,474.13","$3,005.57","$2,474.13",20061001
384,DRG,OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS,N,"$1,475.36","$2,845.59","$1,970.70","$2,845.59",20061001
385,DRG,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",N,"$2,151.46","$3,932.21","$3,953.58","$3,932.21",20061001
386,DRG,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",N,"$1,923.05","$3,514.72","$3,533.83","$3,514.72",20061001
387,DRG,PREMATURITY W MAJOR PROBLEMS,N,"$1,709.00","$3,123.53","$3,140.51","$3,123.53",20061001
388,DRG,PREMATURITY W/O MAJOR PROBLEMS,N,"$1,089.47","$1,991.21","$2,002.02","$1,991.21",20061001
389,DRG,FULL TERM NEONATE W MAJOR PROBLEMS,N,"$1,593.45","$9,310.34","$2,336.14","$9,310.34",20061001
390,DRG,NEONATE W OTHER SIGNIFICANT PROBLEMS,N,$991.96,"$1,812.97","$1,822.84","$1,812.97",20061001
391,DRG,NORMAL NEWBORN,N,$369.03,$674.48,$678.15,$674.48,20061001
392,DRG,SPLENECTOMY AGE >17,S,"$1,233.80","$6,357.34","$2,611.30","$6,357.34",20061001
393,DRG,SPLENECTOMY AGE 0-17,S,"$1,149.77","$5,899.27","$2,482.14","$5,899.27",20061001
394,DRG,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS,S,"$1,666.84","$5,539.58","$3,063.34","$5,539.58",20061001
395,DRG,RED BLOOD CELL DISORDERS AGE >17,N,"$1,343.84","$3,342.75","$2,356.96","$3,342.75",20061001
396,DRG,RED BLOOD CELL DISORDERS AGE 0-17,N,"$1,383.24","$4,039.76","$2,067.32","$4,039.76",20061001
397,DRG,COAGULATION DISORDERS,N,"$1,388.13","$5,065.08","$2,536.83","$5,065.08",20061001
398,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC,N,"$1,447.30","$3,885.81","$2,533.21","$3,885.81",20061001
399,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC,N,"$1,446.86","$3,506.85","$2,914.27","$3,506.85",20061001
401,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC,S,"$1,523.20","$4,794.87","$2,730.03","$4,794.87",20061001
402,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC,S,"$1,611.25","$7,118.60","$2,757.26","$7,118.60",20061001
403,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W CC,N,"$1,506.22","$4,205.55","$2,774.55","$4,205.55",20061001
404,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC,N,"$1,634.75","$4,344.33","$2,432.71","$4,344.33",20061001
405,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17,N,"$1,535.67","$5,020.98","$3,054.60","$5,020.98",20061001
406,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC,S,"$1,732.93","$6,698.07","$3,727.17","$6,698.07",20061001
407,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC,S,"$1,759.86","$8,397.84","$3,388.58","$8,397.84",20061001
408,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC,S,"$1,698.29","$5,865.17","$3,309.09","$5,865.17",20061001
409,DRG,RADIOTHERAPY,N,"$2,121.74","$4,413.24","$4,471.53","$4,413.24",20061001
410,DRG,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS,N,"$2,155.05","$7,656.33","$3,195.39","$7,656.33",20061001
411,DRG,HISTORY OF MALIGNANCY W/O ENDOSCOPY,N,"$1,141.57","$8,102.15",$905.32,"$8,102.15",20061001
412,DRG,HISTORY OF MALIGNANCY W ENDOSCOPY,N,"$3,473.78","$8,956.46","$1,282.40","$8,956.46",20061001
413,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC,N,"$1,390.05","$3,283.00","$2,595.57","$3,283.00",20061001
414,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC,N,"$1,299.14","$2,668.90","$2,151.36","$2,668.90",20061001
417,DRG,SEPTICEMIA AGE 0-17,N,"$2,201.16","$8,526.53","$12,321.20","$8,526.53",20061001
418,DRG,POSTOPERATIVE & POST-TRAUMATIC INFECTIONS,N,"$1,440.92","$2,891.25","$2,725.89","$2,891.25",20061001
419,DRG,FEVER OF UNKNOWN ORIGIN AGE >17 W CC,N,"$1,478.59","$3,472.95","$2,571.37","$3,472.95",20061001
420,DRG,FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC,N,"$1,505.02","$3,195.79","$2,306.13","$3,195.79",20061001
421,DRG,VIRAL ILLNESS AGE >17,N,"$1,409.40","$3,306.52","$2,603.57","$3,306.52",20061001
422,DRG,VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17,N,"$1,282.62","$3,770.76","$3,531.83","$3,770.76",20061001
423,DRG,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES,N,"$1,525.60","$4,294.04","$3,114.50","$4,294.04",20061001
424,DRG,O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS,S,"$1,464.45","$3,020.21","$2,398.33","$3,020.21",20061001
425,DRG,ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION,N,"$1,210.17","$2,781.63","$2,172.88","$2,781.63",20061001
426,DRG,DEPRESSIVE NEUROSES,N,"$1,402.62","$1,352.82","$2,060.37","$1,352.82",20061001
427,DRG,NEUROSES EXCEPT DEPRESSIVE,N,"$1,544.23","$1,331.99","$1,768.63","$1,331.99",20061001
428,DRG,DISORDERS OF PERSONALITY & IMPULSE CONTROL,N,"$1,347.66",$931.94,"$1,730.00",$931.94,20061001
429,DRG,ORGANIC DISTURBANCES & MENTAL RETARDATION,N,"$1,451.92","$1,890.66","$2,320.30","$1,890.66",20061001
430,DRG,PSYCHOSES,N,"$1,480.37",$725.14,"$2,045.20",$725.14,20061001
431,DRG,CHILDHOOD MENTAL DISORDERS,N,"$1,350.93",$812.85,"$1,630.57",$812.85,20061001
432,DRG,OTHER MENTAL DISORDER DIAGNOSES,N,"$1,504.06","$2,233.81","$2,157.83","$2,233.81",20061001
433,DRG,"ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA",N,"$1,642.32","$1,463.92","$3,557.65","$1,463.92",20061001
439,DRG,SKIN GRAFTS FOR INJURIES,S,"$1,490.60","$4,476.61","$3,621.60","$4,476.61",20061001
440,DRG,WOUND DEBRIDEMENTS FOR INJURIES,S,"$1,344.65","$3,564.11","$2,902.97","$3,564.11",20061001
441,DRG,HAND PROCEDURES FOR INJURIES,S,"$1,263.01","$5,478.24","$3,103.97","$5,478.24",20061001
442,DRG,OTHER O.R. PROCEDURES FOR INJURIES W CC,S,"$1,415.03","$5,415.37","$2,905.19","$5,415.37",20061001
443,DRG,OTHER O.R. PROCEDURES FOR INJURIES W/O CC,S,"$1,370.99","$6,206.58","$2,621.94","$6,206.58",20061001
444,DRG,TRAUMATIC INJURY AGE >17 W CC,N,"$1,331.46","$2,985.05","$2,778.13","$2,985.05",20061001
445,DRG,TRAUMATIC INJURY AGE >17 W/O CC,N,"$1,463.45","$2,838.76","$2,832.30","$2,838.76",20061001
446,DRG,TRAUMATIC INJURY AGE 0-17,N,"$1,230.84","$2,024.92","$2,610.15","$2,024.92",20061001
447,DRG,ALLERGIC REACTIONS AGE >17,N,"$1,423.47","$3,572.10","$2,830.43","$3,572.10",20061001
448,DRG,ALLERGIC REACTIONS AGE 0-17,N,"$1,335.67","$2,649.24","$2,629.83","$2,649.24",20061001
449,DRG,POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC,N,"$1,462.47","$4,115.79","$2,863.33","$4,115.79",20061001
450,DRG,POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC,N,"$1,463.80","$3,792.52","$2,660.37","$3,792.52",20061001
451,DRG,POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17,N,$928.16,"$1,997.40","$1,768.58","$1,997.40",20061001
452,DRG,COMPLICATIONS OF TREATMENT W CC,N,"$1,478.50","$3,679.09","$2,903.60","$3,679.09",20061001
453,DRG,COMPLICATIONS OF TREATMENT W/O CC,N,"$1,438.15","$3,294.86","$2,558.21","$3,294.86",20061001
454,DRG,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC",N,"$1,511.59","$3,431.34","$2,934.35","$3,431.34",20061001
455,DRG,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC",N,"$1,501.31","$3,797.46","$3,323.00","$3,797.46",20061001
461,DRG,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES,S,"$1,423.44","$3,908.97","$3,307.94","$3,908.97",20061001
462,DRG,REHABILITATION,N,"$1,313.25","$1,396.01","$2,030.02","$1,396.01",20061001
463,DRG,SIGNS & SYMPTOMS W CC,N,"$1,256.92","$2,644.23","$2,309.13","$2,644.23",20061001
464,DRG,SIGNS & SYMPTOMS W/O CC,N,"$1,311.27","$2,663.97","$2,406.02","$2,663.97",20061001
465,DRG,AFTERCARE W HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS,N,"$1,191.01","$1,945.56","$2,003.85","$1,945.56",20061001
466,DRG,AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS,N,"$1,162.54","$1,680.02","$2,089.56","$1,680.02",20061001
467,DRG,OTHER FACTORS INFLUENCING HEALTH STATUS,N,"$1,618.48","$3,238.34","$3,379.49","$3,238.34",20061001
468,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,S,"$1,476.30","$5,633.89","$2,790.72","$5,633.89",20061001
471,DRG,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY,S,"$1,577.70","$15,079.20","$3,000.10","$15,079.20",20061001
473,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17,N,"$1,595.48","$4,944.18","$2,902.66","$4,944.18",20061001
476,DRG,PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,S,"$1,412.78","$3,216.63","$2,376.49","$3,216.63",20061001
477,DRG,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,S,"$1,405.39","$4,094.19","$2,588.97","$4,094.19",20061001
479,DRG,OTHER VASCULAR PROCEDURES W/O CC,S,"$1,449.62","$12,454.97","$2,577.03","$12,454.97",20061001
480,DRG,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,S,"$2,120.06","$17,189.18","$4,123.25","$17,189.18",20061001
481,DRG,BONE MARROW TRANSPLANT,S,"$3,312.27","$7,420.83","$4,324.41","$7,420.83",20061001
482,DRG,"TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES",S,"$1,612.90","$5,505.60","$3,174.04","$5,505.60",20061001
484,DRG,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,S,"$1,333.68","$7,009.89","$2,955.97","$7,009.89",20061001
485,DRG,"LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA",S,"$1,294.01","$6,624.45","$3,057.41","$6,624.45",20061001
486,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,S,"$1,325.09","$8,315.13","$3,199.56","$8,315.13",20061001
487,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA,N,"$1,404.35","$5,054.19","$3,183.19","$5,054.19",20061001
488,DRG,HIV W EXTENSIVE O.R. PROCEDURE,S,"$2,350.03","$6,886.14","$4,261.93","$6,886.14",20061001
489,DRG,HIV W MAJOR RELATED CONDITION,N,"$2,251.22","$5,283.34","$4,049.36","$5,283.34",20061001
490,DRG,HIV W OR W/O OTHER RELATED CONDITION,N,"$2,163.06","$3,867.22","$2,948.86","$3,867.22",20061001
491,DRG,MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY,S,"$1,295.32","$12,852.09","$2,554.17","$12,852.09",20061001
492,DRG,CHEMOTHERAPY W ACUTE LEUKEMIA OR W USE OF HI DOSE CHEMOAGENT,N,"$2,053.68","$6,320.45","$3,412.15","$6,320.45",20061001
493,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC,S,"$1,241.54","$5,740.47","$2,342.59","$5,740.47",20061001
494,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC,S,"$1,372.05","$8,589.61","$2,262.01","$8,589.61",20061001
495,DRG,LUNG TRANSPLANT,S,"$2,743.04","$24,392.60","$6,138.99","$24,392.60",20061001
496,DRG,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION,S,"$1,937.94","$19,010.47","$4,385.07","$19,010.47",20061001
497,DRG,SPINAL FUSION EXCEPT CERVICAL W CC,S,"$1,309.56","$14,536.13","$2,939.49","$14,536.13",20061001
498,DRG,SPINAL FUSION EXCEPT CERVICAL W/O CC,S,"$1,274.47","$18,407.22","$2,643.44","$18,407.22",20061001
499,DRG,BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC,S,"$1,419.16","$6,971.31","$2,995.46","$6,971.31",20061001
500,DRG,BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC,S,"$1,341.39","$9,374.03","$2,778.97","$9,374.03",20061001
501,DRG,KNEE PROCEDURES W PDX OF INFECTION W CC,S,"$1,327.75","$4,242.64","$2,268.15","$4,242.64",20061001
502,DRG,KNEE PROCEDURES W PDX OF INFECTION W/O CC,S,"$1,231.90","$4,125.85","$1,988.40","$4,125.85",20061001
503,DRG,KNEE PROCEDURES W/O PDX OF INFECTION,S,"$1,332.82","$6,416.41","$2,856.90","$6,416.41",20061001
504,DRG,EXTEN. BURNS OR FULL THICKNESS BURN W/MV 96+HRS W/SKIN GFT,S,"$1,715.20","$7,757.83","$3,991.96","$7,757.83",20061001
505,DRG,EXTEN. BURNS OR FULL THICKNESS BURN W/MV 96+HRS W/O SKIN GFT,N,"$1,254.85","$7,323.43","$4,518.61","$7,323.43",20061001
506,DRG,FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA,S,"$1,577.15","$4,350.16","$4,244.37","$4,350.16",20061001
507,DRG,FULL THICKNESS BURN W SKIN GRFT OR INHAL INJ W/O CC OR SIG TRAUMA,S,"$1,279.85","$3,849.14","$4,025.70","$3,849.14",20061001
508,DRG,FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ W CC OR SIG TRAUMA,N,"$1,377.81","$2,868.53","$4,799.49","$2,868.53",20061001
509,DRG,FULL THICKNESS BURN W/O SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA,N,"$1,224.36","$2,426.01","$6,143.28","$2,426.01",20061001
510,DRG,NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA,N,"$1,466.64","$3,791.53","$5,678.13","$3,791.53",20061001
511,DRG,NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA,N,"$1,520.09","$3,055.67","$6,043.41","$3,055.67",20061001
512,DRG,SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT,S,"$2,247.57","$25,533.67","$5,722.87","$25,533.67",20061001
513,DRG,PANCREAS TRANSPLANT,S,"$2,316.95","$20,591.27","$4,669.55","$20,591.27",20061001
515,DRG,CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH,S,"$1,431.96","$21,483.14","$2,548.12","$21,483.14",20061001
518,DRG,PERC CARDIO PROC W/O CORONARY ARTERY STENT OR AMI,S,"$1,898.81","$12,837.27","$3,016.49","$12,837.27",20061001
519,DRG,CERVICAL SPINAL FUSION W CC,S,"$1,321.34","$11,477.48","$3,031.19","$11,477.48",20061001
520,DRG,CERVICAL SPINAL FUSION W/O CC,S,"$1,235.41","$20,370.47","$2,828.60","$20,370.47",20061001
521,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W CC,N,"$1,336.00","$1,821.63","$2,549.70","$1,821.63",20061001
522,DRG,ALC/DRUG ABUSE OR DEPEND W REHABILITATION THERAPY W/O CC,N,"$1,084.87",$252.51,"$3,035.55",$252.51,20061001
523,DRG,ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O CC,N,"$1,561.18","$1,136.21","$2,526.17","$1,136.21",20061001
524,DRG,TRANSIENT ISCHEMIA,N,"$1,387.42","$4,040.92","$2,436.60","$4,040.92",20061001
525,DRG,OTHER HEART ASSIST SYSTEM IMPLANT,S,"$1,852.43","$20,292.67","$4,070.32","$20,292.67",20061001
528,DRG,INTRACRANIAL VASCULAR PROC W PDX HEMORRHAGE,S,"$2,018.67","$9,899.04","$4,234.55","$9,899.04",20061001
529,DRG,VENTRICULAR SHUNT PROCEDURES W CC,S,"$1,561.10","$6,054.94","$3,203.65","$6,054.94",20061001
530,DRG,VENTRICULAR SHUNT PROCEDURES W/O CC,S,"$1,497.45","$9,639.91","$3,104.56","$9,639.91",20061001
531,DRG,SPINAL PROCEDURES W CC,S,"$1,456.86","$6,897.79","$3,091.34","$6,897.79",20061001
532,DRG,SPINAL PROCEDURES W/O CC,S,"$1,611.60","$9,160.57","$3,382.97","$9,160.57",20061001
533,DRG,EXTRACRANIAL PROCEDURES W CC,S,"$1,376.79","$8,439.83","$2,608.70","$8,439.83",20061001
534,DRG,EXTRACRANIAL PROCEDURES W/O CC,S,"$1,395.30","$13,083.51","$2,802.18","$13,083.51",20061001
535,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK,S,"$2,100.29","$20,422.56","$3,256.92","$20,422.56",20061001
536,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK,S,"$1,904.79","$22,395.10","$2,940.22","$22,395.10",20061001
537,DRG,LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W CC,S,"$1,424.44","$5,410.91","$2,897.72","$5,410.91",20061001
538,DRG,LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O CC,S,"$1,402.12","$7,749.10","$2,572.16","$7,749.10",20061001
539,DRG,LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W CC,S,"$1,548.02","$6,121.92","$2,929.04","$6,121.92",20061001
540,DRG,LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W/O CC,S,"$1,676.76","$8,445.19","$3,231.66","$8,445.19",20061001
541,DRG,"ECMO OR TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R.",S,"$2,015.36","$8,134.50","$3,696.04","$8,134.50",20061001
542,DRG,"TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.",S,"$2,189.10","$6,523.18","$3,780.34","$6,523.18",20061001
543,DRG,CRANIOTOMY W MOJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS,S,"$1,528.80","$7,357.18","$3,482.71","$7,357.18",20061001
544,DRG,MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY,S,"$1,571.83","$5,245.09","$3,216.54","$5,245.09",20061001
545,DRG,REVISION OF HIP OR KNEE REPLACEMENT,S,"$1,632.56","$6,907.00","$3,222.30","$6,907.00",20061001
546,DRG,SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG,S,"$1,912.75","$12,812.98","$3,600.79","$12,812.98",20061001
547,DRG,CORONARY BYPASS W CARDIAC CATH W MAJOR CV DX,S,"$2,151.64","$21,673.40","$4,332.82","$21,673.40",20061001
548,DRG,CORONARY BYPASS W CARDIAC CATH W/O MAJOR CV DX,S,"$2,082.57","$6,885.81","$4,281.33","$6,885.81",20061001
549,DRG,CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX,S,"$1,912.75","$12,812.98","$3,600.79","$12,812.98",20061001
550,DRG,CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX,S,"$1,636.21","$6,404.16","$3,256.95","$6,404.16",20061001
551,DRG,PERMANENT CARDIAC PACEMAKER IMPL W MAJ CV DX OR AICD LEAD OR GNRTR,S,"$1,619.99","$7,331.82","$3,283.71","$7,331.82",20061001
552,DRG,OTHER PERMANENT CARDIAC PACEMAKER IMPLANT W/O MAJOR CV DX,S,"$1,613.63","$5,354.12","$3,245.61","$5,354.12",20061001
553,DRG,OTHER VASCULAR PROCEDURES W CC W MAJOR CV DX,S,"$1,621.74","$7,449.64","$3,285.09","$7,449.64",20061001
554,DRG,OTHER VASCULAR PROCEDURES W CC W/O MAJOR CV DX,S,"$1,620.57","$5,423.98","$3,276.82","$5,423.98",20061001
555,DRG,PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX,S,"$1,636.84","$7,006.24","$3,229.73","$7,006.24",20061001
556,DRG,PERCUTANEOUS CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MAJ CV DX,S,"$1,612.59","$5,448.24","$3,331.92","$5,448.24",20061001
557,DRG,PERCUTANEOUS CARDIOVASCULAR PROC W DRUG-ELUTING STENT W MAJOR CV DX,S,"$1,579.41","$5,698.64","$3,115.30","$5,698.64",20061001
558,DRG,PERCUTANEOUS CARDIOVASCULAR PROC W DRUG-ELUTING STENT W/O MAJ CV DX,S,"$1,653.94","$6,655.39","$3,316.51","$6,655.39",20061001
559,DRG,ACUTE ISCHEMIC STROKE WITH USE OF THROMBOLYTIC AGENT,N,"$1,524.31","$5,636.66","$4,212.88","$5,636.66",20061001
560,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,N,"$1,606.68","$3,147.11","$2,877.78","$3,147.11",20061001
561,DRG,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,N,"$1,304.48","$3,581.71","$2,770.47","$3,581.71",20061001
562,DRG,SEIZURE AGE > 17 W CC,N,"$1,372.36","$3,229.79","$2,647.12","$3,229.79",20061001
563,DRG,SEIZURE AGE > 17 W/O CC,N,"$1,402.41","$2,748.89","$2,856.34","$2,748.89",20061001
564,DRG,HEADACHES AGE >17,N,"$1,374.30","$2,772.27","$2,712.99","$2,772.27",20061001
565,DRG,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS,N,"$1,923.05","$3,514.73","$3,533.84","$3,514.73",20061001
566,DRG,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT < 96 HOURS,N,"$1,369.34","$4,711.85","$3,761.09","$4,711.85",20061001
567,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W CC W MAJOR GI DX",S,"$1,702.54","$11,458.88","$3,241.18","$11,458.88",20061001
568,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES PROC AGE > 17 W CC W/O MAJOR GI DX",S,"$1,385.42","$4,903.46","$2,859.52","$4,903.46",20061001
569,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W MAJOR GI DX,S,"$1,857.88","$10,300.00","$3,887.54","$10,300.00",20061001
570,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W/O MAJOR GI DX,S,"$1,387.75","$5,758.14","$2,736.85","$5,758.14",20061001
571,DRG,MAJOR ESOPHAGEAL DISORDERS,N,"$1,374.88","$3,233.90","$2,642.68","$3,233.90",20061001
572,DRG,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS,N,"$1,430.76","$3,184.81","$2,948.25","$3,184.81",20061001
573,DRG,MAJOR BLADDER PROCEDURES,S,"$1,468.90","$6,861.41","$3,013.70","$6,861.41",20061001
574,DRG,MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL,N,"$1,362.98","$3,022.27","$2,769.95","$3,022.27",20061001
575,DRG,SEPTICEMIA W MV96+ HOURS  AGE  >17,N,"$1,923.05","$3,514.73","$3,533.84","$3,514.73",20061001
576,DRG,SEPTICEMIA W/O MV96+ HOURS AGE  >17,N,"$1,344.39","$3,502.77","$2,475.08","$3,502.77",20061001
577,DRG,CAROTID ARTERY STENT PROCEDURE,S,"$1,455.46","$6,451.41","$2,942.22","$6,451.41",20061001
578,DRG,INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE,S,"$1,702.54","$11,458.88","$3,241.18","$11,458.88",20061001
579,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W OR PROCEDURE,S,"$1,444.17","$6,532.37","$2,873.28","$6,532.37",20061001
999,SNF,SKILLED NURSING FACILITY PER DIEM,,$791.44,,,,20061001